NEW YORK (Reuters Health) - Adults treated in the emergency
room for severe asthma often continue to have poorly controlled
symptoms afterward, new research suggests.

In a study of 225 adults who visited an ER for an asthma
flare-up, researchers found that most patients had suffered
persistent symptoms during the previous month, and only about
half of them were taking inhaled steroids to help prevent
asthma attacks.

One month after the ER visit, many still had poorly
controlled symptoms, the researchers report in the Annals of
Allergy, Asthma and Immunology.

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The findings suggest that emergency care for asthma can be
better, and that the "bridge" between the ER and the doctor's
office can be stronger, write Dr. Richard O. Lenhardt, of Rush
University Medical Center in Chicago, and his colleagues.

In the ER, asthma exacerbations are usually treated with
oral corticosteroid medication, Lenhardt explained, but this is
a short- term solution. If patients do not get their asthma
under better control, they are at risk of seeing their symptoms
worsen again once they stop taking the oral drugs, he told
Reuters Health.

The problem is that many people do not go to see their
primary care doctor after their ER visit, according to
Lenhardt. He said that emergency physicians may be able to do
more to encourage patients to see their regular doctor as soon
as possible.

The study involved 225 adults who had an asthma
exacerbation treated at one of six Illinois ERs over six
months. The researchers questioned them about their symptoms
and medication use in the previous month, then called them one
month after the ER visit to see how they were faring.

Nearly 86 percent of patients said they'd had persistent
asthma symptoms in the month before the ER visit. Of this
group, only 54 percent were using inhaled corticosteroids,
despite the fact that national guidelines recommend that this
be the primary therapy for such patients.

Even fewer -- about one-quarter -- were using inhaled
corticosteroids daily to prevent symptoms, the study found.

One month after their ER visit, more patients were on
inhaled corticosteroids, with three-quarters saying they used
the medications and 59 percent reporting daily use. However,
many patients still had problems with controlling their
symptoms.

Just as many reported persistent symptoms after their ER
visit as before, the researchers found. Furthermore, on a
standard measure of quality of life, the average score for the
study group was lower than what has been found for adults with
asthma in general.

For adults who've had to get emergency asthma care, the
bottom line is that they should talk to their doctor about how
to get a better handle on the disease.

"It might mean they need more medication, better avoidance
of allergens, better use of the current medications, and other
reasons that could be sorted out by their primary care
physician," Lenhardt said.